Can Thrombolytic Therapy Improve Vision in Patients With CRVO?

In a study published in Retina, patients with CRVO receiving tPA were found to have improved visual acuity, but no change in the rate of neovascularization. The study compared 20 patients with CRVO receiving tissue plasminogen activator against the control group of 21 patients receiving hemodilution for CRVO. It also included patients with BRVO. Participants in the study had a best-corrected visual acuity of < 20/50 and sustained the occlusive incident within 11 days.

The mean visual acuity in the tPA group was 20/60 compared to 20/400 in the hemodilution group. More patients in the thrombolytic group experienced an improvement of 3 lines or more compared to the control group. Interestingly, equal numbers of patients developed iris neovascularization in this 1 year study. There was no difference in results with patients with BRVO.